Video cameras are increasingly being utilized for medical procedures. For instance, video laryngoscopes are being utilized to aide the physician in intubating patients. In addition, endoscopes are also being increasingly utilized by physicians in non-invasive procedures for observing a body cavity.
A number of challenges confront physicians in performing surgical procedures. For instance, one of the foremost obstacles encountered by an anesthesiologist in the intubation process include; the remoteness of the location where the tube is to be positioned, the consequent restriction of view as the tube is inserted, variations and anomalies in the anatomy of the patients, an uncomfortable and unnatural position for the anesthesiologist while holding the instrument, the potential need to change blades during the procedure, and the necessity for rapid intubation.
During the intubation process, it should be noted that when the tube is inserted, the patient is asleep, hyperoxygenated and then paralyzed for the procedure, and therefore not breathing. In addition, the ventilator is not yet in operation. This gives the anesthesiologist only about two minutes in which to intubate the patient, inflate the cuff, and start ventilation. If he is delayed because of unsuccessful attempts, he must stop, apply a ventilation mask to the patient, supply oxygen for a time through the mask, remove the mask, adjust medication if necessary, and then start over again. This delays the operation and extends the patient's time under anesthesia. This extension of time while under anesthesia may have very serious consequences, especially for elderly patients.
So too in surgical procedures in which an endoscope is utilized, the quicker and easier the endoscope is to use, the sooner the physician can complete the procedure and bring the patient out from under anesthesia.
With the advent of endoscopic equipment and small cameras, instrumentation has been improved to the extent that it can enable viewing of internal structures such as: the vocal cords and larynx, or any other anatomical feature to be viewed on a video screen. This greatly increases the ease of, for instance, intubation of the patient or viewing of the area in which the surgical procedure is to take place. However, laryngoscopes and endoscopes may be further improved such that they are easier to use, reducing the time involved in, for instance, changing a camera or light and image attachment.
Video laryngoscopes and endoscopes typically contain a light guiding system, usually in the form of fiber optic cables, in order to bring light to the surgical area. The light guiding system typically extends through a handle of the device and to an end portion to be inserted into the body. With a laryngoscope, the blade typically extends through a guide tube located in the blade so as to position the light guiding system to illuminate the area ahead of the blade. Video laryngoscopes and endoscopes also typically contain an image guiding system, for example in the form of a rigid rod lens system. The image guiding system can also be configured as an ordered, flexible fiber optic bundle. The image guiding system is utilized to transmit reflected light from the surgical area to the camera. With a laryngoscope, the image guiding system is utilized to transmit reflected light from ahead of the blade to a camera. The camera, attached at the proximal end of the device, usually contains a CCD (charge coupled device) sensor, in the form of a light-sensitive chip that converts the optical signals into electrical signals that are conveyed from the image-sensing camera module to a remotely located image processing system.
Typically, the combination light guiding system and image guiding system are permanently attached to the handle of the video laryngoscope or endoscope and are continuous, extending from the distal end of the device, through the handle and to the camera for the image guiding system, and to the light source for the light guiding system. Therefore, the light guiding system and image guiding system extending from the handle of the device for insertion typically comprise flexible coherent fiber optic bundles. However, in the case of a video laryngoscope, when changing blades, the fiber optic bundle must be carefully inserted or withdrawn from the opening of the guide tube at the proximal end of the blade. This may take an unacceptable amount time for the physician to thread the bundle into the tube if the blade must be changed in the middle of the intubation process. In addition, in the case of an endoscope, if the camera unit must be changed in the middle of a procedure, it is undesirable to have to remove the endoscope to do this.
The light and image guiding systems have typically been permanently attached to the handle to ensure the system will reliably transmit the illuminating light and reflected images. To utilize a detachably connectable light and image guiding system, the attachment means would have to rigidly hold the member in place such that the light and image guiding systems did not become misaligned. In addition, the attachment means must be easy and quick to operate, making it possible to perform the coupling procedure with as little close attention as possible, but nevertheless reliably. Provision must therefore be made for the coupling elements to be keyed to each other so that the coupling cannot be incorrectly joined and so that close attention by the operation is not required.
In addition, the flexible bundles may easily be damaged and will wear over time, degrading or rendering the system inoperable. As a visual inspection of the device often will not indicate whether the bundles are damaged, it is conceivable that a physician may obtain a damaged or malfunctioning device not realizing that it is damaged. The time involved with determining that the instrument is malfunctioning, withdrawing it, finding another device, and then proceeding with the procedure may have severe adverse effects upon the patient under anesthesia.
Further, video laryngoscopes and endoscopes, as with most medical equipment, must be sterilized after use. Because the light and image guiding systems are permanently attached to the handle, they are exposed to extremely high temperatures, which also cause wear and/or failure of the flexible bundles. In addition, because the camera unit, and the light and image guiding systems are permanently located in the handle, they must be subjected to the sterilization process with the handle and blades, which means that the handle must be hermetically sealed. This can greatly add to the cost in manufacturing the device.
It is therefore desired to provide an improved attachment device that is easy to use and will facilitate the quick removal and reattachment of a camera unit and a light and image guiding attachment.
It is also desired to provide a highly durable light and image guiding attachment that may readily be removed from and attached to a camera unit.
It is further desired to provide an improved attachment device that will reduce manufacturing costs associated with a combination camera unit and light and image guiding attachment.
It is still further desired to provide an improved attachment device that will reliably connect a camera unit and a light and image guiding attachment, while requiring a minimal amount of attention from the user to attach or detach.
It is yet further desired to provide an improved attachment device for use with a video laryngoscope or an endoscope.
It is still further desired to provide a video laryngoscope according to the forgoing having an interchangeable blade.